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Quantifying life: Understanding the history of Quality-Adjusted Life-Years (QALYs)
Quality-Adjusted Life-Years (QALYs) are central to healthcare decision-making in Britain and abroad, yet their history is poorly understood. In this paper, we argue that a more in-depth and political history of the QALY is needed to allow a critical evaluation of its current dominance. Exploiting ri...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Pergamon
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6079188/ https://www.ncbi.nlm.nih.gov/pubmed/30015244 http://dx.doi.org/10.1016/j.socscimed.2018.07.004 |
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author | MacKillop, Eleanor Sheard, Sally |
author_facet | MacKillop, Eleanor Sheard, Sally |
author_sort | MacKillop, Eleanor |
collection | PubMed |
description | Quality-Adjusted Life-Years (QALYs) are central to healthcare decision-making in Britain and abroad, yet their history is poorly understood. In this paper, we argue that a more in-depth and political history of the QALY is needed to allow a critical evaluation of its current dominance. Exploiting rich data from archives and 44 semi-structured interviews conducted between 2015 and 2018, we employ Multiple Streams Analysis to construct a complex and dynamic picture of how the idea of QALYs emerged and was adopted within UK health policy. Through its historical and political approach, the paper illuminates the relative roles in the policy-making process of experts (especially economists) and politicians as ‘entrepreneurs’ in the development of new ideas; how these were influenced by negotiation within established and emerging institutional structures; and the role of serendipity and crisis. |
format | Online Article Text |
id | pubmed-6079188 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Pergamon |
record_format | MEDLINE/PubMed |
spelling | pubmed-60791882018-08-10 Quantifying life: Understanding the history of Quality-Adjusted Life-Years (QALYs) MacKillop, Eleanor Sheard, Sally Soc Sci Med Article Quality-Adjusted Life-Years (QALYs) are central to healthcare decision-making in Britain and abroad, yet their history is poorly understood. In this paper, we argue that a more in-depth and political history of the QALY is needed to allow a critical evaluation of its current dominance. Exploiting rich data from archives and 44 semi-structured interviews conducted between 2015 and 2018, we employ Multiple Streams Analysis to construct a complex and dynamic picture of how the idea of QALYs emerged and was adopted within UK health policy. Through its historical and political approach, the paper illuminates the relative roles in the policy-making process of experts (especially economists) and politicians as ‘entrepreneurs’ in the development of new ideas; how these were influenced by negotiation within established and emerging institutional structures; and the role of serendipity and crisis. Pergamon 2018-08 /pmc/articles/PMC6079188/ /pubmed/30015244 http://dx.doi.org/10.1016/j.socscimed.2018.07.004 Text en © 2018 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article MacKillop, Eleanor Sheard, Sally Quantifying life: Understanding the history of Quality-Adjusted Life-Years (QALYs) |
title | Quantifying life: Understanding the history of Quality-Adjusted Life-Years (QALYs) |
title_full | Quantifying life: Understanding the history of Quality-Adjusted Life-Years (QALYs) |
title_fullStr | Quantifying life: Understanding the history of Quality-Adjusted Life-Years (QALYs) |
title_full_unstemmed | Quantifying life: Understanding the history of Quality-Adjusted Life-Years (QALYs) |
title_short | Quantifying life: Understanding the history of Quality-Adjusted Life-Years (QALYs) |
title_sort | quantifying life: understanding the history of quality-adjusted life-years (qalys) |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6079188/ https://www.ncbi.nlm.nih.gov/pubmed/30015244 http://dx.doi.org/10.1016/j.socscimed.2018.07.004 |
work_keys_str_mv | AT mackillopeleanor quantifyinglifeunderstandingthehistoryofqualityadjustedlifeyearsqalys AT sheardsally quantifyinglifeunderstandingthehistoryofqualityadjustedlifeyearsqalys |